Inspection on 24/05/05 for Cedar House

This inspection was carried out on 24th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Cedar House 23/02/10

Cedar House 27/11/09

Cedar House 14/05/09

Cedar House 29/05/08

Cedar House 11/01/07

Cedar House 09/05/06

Cedar House 14/09/05

Cedar House 04/11/04

Cedar House 06/04/04

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Cedar House 47 Smethurst Street Middleton Manchester M24 2BA Lead Inspector Tracey Devine Unannounced 24 May 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Cedar House F06 F56 S41209 Cedar House V228670 24.05.05 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Cedar House Address 47 Smethurst Street, Middleton, Manchester, M24 2BA. 0161 6553553 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Ann Merabi Care Home 16 Category(ies) of Mental Disorder 16, Mental Disorder Elderly 3 registration, with number of places Cedar House F06 F56 S41209 Cedar House V228670 24.05.05 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1.The home is registered for a maximum number of 16 service users to include 16 service users in the category of MD (Mental disorder) and up to3 service users in the category of MD(E) (Mental disorder excluding learning disability or dementia over 65 years of age) within the total number of 16. 2. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Date of last inspection 4th November 2004 Brief Description of the Service: Cedar House is a care home providing personal care for 16 residents who have been diagnosed with a mental disorder. The home provides 16 single bedrooms, a lounge, conservatory, dining room and communal toileting and bathing facilities. Cedar House is located at the end of a residential street, approximately 2 miles from the town centre of Middleton. A number of small local shops, post office, and pubs are near by. The home has a car park for residents and visitors. Cedar House F06 F56 S41209 Cedar House V228670 24.05.05 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 24th May 2005 by one inspector. A total of 7 hours were spent at the home. Time was spent time talking with 4 residents to see what they thought of the home, and the Inspector had lunch with the residents. Time was also spent talking with 2 staff, the owners of the home, and looking at records kept. The areas looked at on this inspection were: how residents spent their time; how their social, emotional, physical and mental health needs were met; how staff supported them; whether the staffing levels of the home were enough, and if staff had any training which helped them to do their job better. Since the last inspection, the registered manager has left. The owner has appointed another member of staff to manage the home, but as yet this person has not sent an application form in for the position of registered manager to the CSCI. The CSCI has made 2 extra visits to the home since the last inspection, to check that the areas identified at the last inspection for action have been done. The owner has now done everything that the CSCI asked him to do from the last inspection. 1 complaint has been received at CSCI since the last inspection. This complaint was made by a visitor to the home and was about staff smoking in the resident’s lounge. The previous manager looked into the complaint and said that it was true but it was something that should not be happening and that she had told staff not to do this. Staff have been told again that they must not smoke in the residents lounge. What the service does well: The home is small and homely. The relationship between residents and staff is good, and residents said they felt comfortable around staff. Residents described staff as “kind”, “friendly”, “helpful” by residents. Residents are encouraged and supported by staff to live the life they choose. They can go to bed when they want, and get up when they want. They can leave the home when they want and return when they want. They can have personal possessions in their bedrooms and choose their own furniture and colour of their bedrooms. They can meet friends, or choose to stay in if they want. They can wear what they want. Cedar House F06 F56 S41209 Cedar House V228670 24.05.05 Stage 4.doc Version 1.30 Page 6 The home offers a relaxed environment and residents spoken with used words such as “homely”, “comfortable”, and “well cared for” to describe Cedar House. What has improved since the last inspection? What they could do better: The manager and staff need to be better at reading information provided by the care manager regarding a resident and including this information on the care plan. This will mean that the areas which the care manager feels the resident needs help with are known to staff and they can then give the care needed. The inspector told the owner that this information must be obtained and written onto care plans by the end of the day. The menu needs to include more healthy options for residents and staff must be more active in giving residents a choice of meal. It should not be left to the resident to have to ask. Residents gave the inspector ideas for food they would like to see included – malt loaf, cheese and crackers were suggestions for supper. Staff need to be more proactive in this area. The home currently does not have enough staff. The owner has employed more staff but is waiting for references and police checks on these staff to come through. In the meantime, existing staff are working long hours. The long hours mean they are becoming tired and some are going off sick. Some staff are being asked to work the night duty, and then stay on for the day duty. This is too long and results in staff not working as well as they should. The manager was off sick on the day of this inspection, and the staff rota showing who was to work that week had not been done. Staff did not know when they were next due to work. The inspector told the owner that a rota showing who was working must be in place by the end of the day. Staff do receive general training. This lack of training for mental health awareness includes the manager. However, as the home is to care for residents who have a mental health illness, then staff must receive training on looking after people with a mental illness. No checking of the fire alarm or checking to make sure fire exits have not become blocked has taken place for around 6 months. The inspector told the owner that this was dangerous and presents a clear risk to residents. He was Cedar House F06 F56 S41209 Cedar House V228670 24.05.05 Stage 4.doc Version 1.30 Page 7 told that he must do a fire alarm check and check all the fire exits were clear by the end of the day. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Cedar House F06 F56 S41209 Cedar House V228670 24.05.05 Stage 4.doc Version 1.30 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Cedar House F06 F56 S41209 Cedar House V228670 24.05.05 Stage 4.doc Version 1.30 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2, 4 Satisfactory systems are in place for individuals to visit the home and meet the staff, other residents and view the facilities. Assessment of need is made before the resident moves into the home to ensure that the home can provide the care needed by the individual. The home lacks a formal system for ensuring that all information is shared with staff resulting in some residents needs remaining unknown and therefore unmet. EVIDENCE: Residents are admitted to the home following a full assessment undertaken by their funding care manager. 3 assessments were looked at and contained detailed information on the resident’s social, physical and mental well-being. 1 assessment also included restrictions to be in place in line with appropriate legislation. In the main, it was noted that most of the information supplied by the care manager had been transferred onto the home’s care plan. However, some information detailed on 2 of the assessments had not been transferred by staff and could easily be lost on the file and not become known to the staff. 1 member of staff spoken with admitted that she did not know some of this information and said she had not had time to read the files. 1 file in particular contained information in respect of restrictions and staff action to be taken should a restriction be breached by the resident. This file was not well planned with no dividers in use making it difficult to access relevant information quickly in an emergency. Cedar House F06 F56 S41209 Cedar House V228670 24.05.05 Stage 4.doc Version 1.30 Page 10 Residents are able to spend time at the home before they move in and they may take their time in moving in starting with a short visit having a hot drink and a meal, and building up to an overnight stay until they feel comfortable in moving into the home permanently. Cedar House F06 F56 S41209 Cedar House V228670 24.05.05 Stage 4.doc Version 1.30 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 8, 9 Overall, residents are encouraged to make their own decisions regarding how they live and are supported by staff in accessing services in the community, allowing them to lead a normal life. The care planning system does not always provide staff with adequate information to meet residents needs and therefore fails to ensure that all the care needs of residents are identified and met. EVIDENCE: In the main, the care plans in place detail the physical, social and mental health needs of the resident as identified by staff using the information supplied by care managers. However, 2 care plans did not fully show the care to be delivered as identified by the care manager, and on discussion with staff it was evident that the some needs and areas to be worked on by staff at the home had not been introduced with the regularity requested by the care manager. The daily progress notes completed by staff also did not demonstrate that such activity had taken place. Staff spoken with had some knowledge of the areas (preparation of meals, budgeting, weight monitoring) and said they did do them, but admitted they did not take place as frequently as outlined by the care manager, nor could they identify what the frequency should actually be. Cedar House F06 F56 S41209 Cedar House V228670 24.05.05 Stage 4.doc Version 1.30 Page 12 A number of care plans showed resident involvement and on discussion 2 residents said they had read the care plan and signed it. All the residents spoken with said they felt the staff looked after them well, and that staff helped them if they needed it. A number of residents lead fairly independent lives and staff support them in accessing all aspects of the community. This may involve them accompanying residents or providing encouragement. On the day of this inspection, staff had arranged for a person from the local college to visit the home and speak with residents regarding accessing college courses. Residents are encouraged to participate and make decisions about the running of the home. Formal systems such as relative meetings take place which are minuted, and informally staff and residents chat about what changes they would like to see made. The main areas for change which residents influence were decoration and furnishing of their bedroom, what to watch on TV, and how to spend their day. Risk assessments are generally incorporated into the care plan rather than being a separate document. The staff have got a number of restrictions in place regarding smoking and cigarettes and the risk presented by fire. No formal risk assessments were in place demonstrating the reasons for the restrictions imposed in relation to smoking. Cedar House F06 F56 S41209 Cedar House V228670 24.05.05 Stage 4.doc Version 1.30 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 15, 16, 17 The home promotes residents’ involvement in community life ensuring they lead as normal a life as they can. The menu is traditional, lacks variety and does not promote healthy living. EVIDENCE: Residents are encouraged and supported by staff (if necessary) to take part in community life and mix with a variety of other people. Residents gave examples of how they spent their day at the home, and which places they liked to visit. Shopping in Middleton, going to the cinema, garden centre, pubs, visiting family and friends were all mentioned. A number of residents also attend the local day centre for people with mental health problems regularly. None of the residents attend college or access other forms of further education, or undertake voluntary work. The manager had arranged for a representative from the local college to visit the home to inform residents of courses available. Cedar House F06 F56 S41209 Cedar House V228670 24.05.05 Stage 4.doc Version 1.30 Page 14 Visitors are welcomed to the home and residents may make use of their bedroom for seeing visitors in private, or access the conservatory if they want some privacy but do not want to use their bedroom. A number of residents have family members who visit regularly. A cyclical menu is in place, and was said to be under review with residents. The menu shows traditional food to be served. The menu did not demonstrate that residents receive the recommended daily allowance of 5 portions of fruit and vegetables daily. The main meal of the day is served in the evening, with a light snack type meal served at lunchtime. The owner said that there is always a choice of food available and residents may have something else if they do not like what is being served. From speaking with residents and staff, the reality is that the meal detailsed on the menu is the meal served to everyone, with any known dislikes accommodated with some variation of the set meal. For instance, on the day of the inspection, the lunchtime meal was beans on toast, 1 resident known not to like beans was served egg on toast. No system is in place for promoting choice at meal times with the responsibility lying with the resident to request something else. No dessert is routinely offered after the lunchtime meal and this was confirmed by staff and residents. Again the emphasis is with the resident to request a dessert, and this was said to rarely happen with residents accepting what has been provided to them. At the request of the inspector, yoghurt and fruit were offered to residents following lunch and all residents took this offer up choosing either a yoghurt or apple. The evening meal is more substantial and served with a dessert. The menu shows a range of food available at breakfast and supper time, although on discussion with residents it is the same few foods which are offered by staff. Residents said overall they enjoyed the food and that they received sufficient to eat. 1 resident said they would like to see more variety of food offered at supper time. The usual choice was said to be bread and jam. Residents nutritional needs are assessed on admission, but no regular monitoring of weight is undertaken owing to the scales being broke. Cedar House F06 F56 S41209 Cedar House V228670 24.05.05 Stage 4.doc Version 1.30 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19, 20 Residents personal and health care needs are met, with residents own routines within the home promoted and accommodated. EVIDENCE: Residents spoken with gave examples of how staff assisted them in aspects of personal care. Much of this was prompting and encouragement to wash and change their clothes daily. Assistance with physical care is not generally required with all residents being independent in this area. Residents access health care in the community, and appointments with mental health professionals are noted in the office diary. CPN’s and other health professionals visit the home to see individual residents. Residents routines for rising, retiring, dressing, personal styles are respected and this was evident through observations on the day. Residents commented that they felt they could live as they choose to at Cedar House. The medication system in place has recently been inspected by the CSCI pharmacist inspector and the home has put into place most of the areas identified by the pharmacist inspector. The manager is currently in the process of updating the medication policy/procedure. Cedar House F06 F56 S41209 Cedar House V228670 24.05.05 Stage 4.doc Version 1.30 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22, 23 The home has a complaints procedure in place, known to residents and relatives. The home’s policy and procedure on the protecting residents from abuse is known to staff, ensuring that they know what steps need to be taken if they suspect or witness any abuse towards a resident. EVIDENCE: The home’s complaint procedure is clearly displayed in the entrance hall and in the service user guide – a copy of which everyone has in their bedroom. The majority of the residents have access to a care manager, and a number hold regular reviews with the resident at the home. Residents said they would speak with a member of staff if they had concerns in any way, and all knew the owners visited several times a week and said that they would speak with one of the owners if they felt concerned. The CSCI has received 1 complaint about the home since the last inspection. This related to staff using the residents lounge when they wanted to have a cigarette. The owner investigated the complaint and found it to be upheld. Staff now are required to smoke outside the premises. The home has policies and procedures in place relating to the Protection of Vulnerable Adults and staff spoken with on the day were conversant with the procedure they would adopt. Cedar House F06 F56 S41209 Cedar House V228670 24.05.05 Stage 4.doc Version 1.30 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: None of the above standards were inspected on this occasion. inspected on the next inspection. They will be Cedar House F06 F56 S41209 Cedar House V228670 24.05.05 Stage 4.doc Version 1.30 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 35 The deployment and numbers of staff are usually sufficient to meet the needs of the residents. However, poor recruitment practice has impacted on the number of staff available to work and the deployment of the existing staff in covering additional hours has not been well managed. Whilst this has resulted in continuity of staff for residents, the impact of excessive hours worked by staff is taking its toll resulting in sickness levels starting to rise. The staff group have received general training but lack formal training on the meeting the needs of people with a mental health problem. Staff interaction with residents is good, positive and demonstrates the bond established between the longer standing members of staff, and residents. EVIDENCE: The recruitment practice within recent months has been poor with staff recruited without appropriate checks having been done. This poor practice was identified by the CSCI during an additional visit made. As a result of this, staff who had not been appropriately checked were sent home by the owner whilst references and a police check were undertaken. The owner has covered the shortfall in hours by asking existing staff to undertake extra hours. It was noted on past rotas that some staff were working very long hours, and on occasion some staff were coming from night duty straight onto day duty – this Cedar House F06 F56 S41209 Cedar House V228670 24.05.05 Stage 4.doc Version 1.30 Page 19 occurred on the day of the inspection. On the day of this inspection 2 staff (manager and deputy) were both off sick resulting in the home being short staffed with only 2 members of staff being on duty. In addition to being support workers, these staff were also expected to undertake cooking and cleaning duties, and one had been on the “waking” night duty. The owner was contacted and arranged for additional staff to come into the home. It was also noted that the rota for the week had not been done, and staff were unaware of when they were next due to work. . A number of the staff have been employed at the home for some years, and are experienced caring for residents with a mental illness. However, no specialist training on mental health awareness or working with people with mental health problems has been provided. NVQ training has been taken up by some support workers, and a number of other training courses have been accessed by staff. However, no overall training programme detailing which staff have attended which course and when could be located. Nor did staff files looked at consistently contain copies of staff qualifications. Some staff said they kept such certificates at home and had not been asked to bring them in. Staff were observed to have positive interactions with residents, and residents did say they felt to be well cared for by staff they could be comfortable with. Cedar House F06 F56 S41209 Cedar House V228670 24.05.05 Stage 4.doc Version 1.30 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 Arrangements for maintaining the health and safety of residents are in place in all aspects except fire safety. This shortfall in fire safety puts residents at risk especially in view of the high number of residents who smoke on the premises. EVIDENCE: The owner has systems in place with local contractors for maintenance of equipment, redecoration to the home, gardening etc. Annual checks on gas and electrical appliances are undertaken and certificates confirmed this. The fire equipment was last serviced in November 2004. The fire log book showed that procedures for weekly testing of the fire alarm, means of escape etc had not been undertaken for some 6 months. Staff had not recently had fire drill training. A new carpet had been fitted to the communal lounge providing a homely feel. The door linking the conservatory and the lounge had been removed to accommodate the fitting of the carpet and have yet to be refitted. Cedar House F06 F56 S41209 Cedar House V228670 24.05.05 Stage 4.doc Version 1.30 Page 21 The owner said he was waiting for the joiner to attend to them and put them back on. The lighting in the lounge was dim owing to only 3 of a possible 12 bulbs in the ceiling lights working. Cedar House F06 F56 S41209 Cedar House V228670 24.05.05 Stage 4.doc Version 1.30 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 1 x 3 x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 1 3 3 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x Standard No 11 12 13 14 15 16 17 x 3 3 3 3 3 1 Standard No 31 32 33 34 35 36 Score x 2 2 x 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Cedar House Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score x x x x x 1 x F06 F56 S41209 Cedar House V228670 24.05.05 Stage 4.doc Version 1.30 Page 23 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. Standard 2 6 9 17 33 35 33 33 42 42 42 Regulation 14(1) 14(1) 12(3) 12(1) & 16(2) 17 18 18 18 23 23 23 Requirement Information supplied by the care manager must be transferred onto the care plan Specific action on assessed needs as identifed by the care manager must be put into place. Risk assessments on the resrtiction of liberty ie smoking must be put into place. The menu must incorporate more healthy foods ie 5 portions of fruit and vegetables daily. A staff rota must always be in place. Staff must receive specialist training in respect of mental health awareness, etc. Sufficient staff must always be on duty. A training profile detailing all staff and training attended (dates of) must be in place . The fire log book must be brought up to date and kept up to date. The doors linking the conservatory and the lounge must be refitted. The broken bulbs in the ceiling light in the lounge must be replaced. Timescale for action 24th May 2005 24th May 2005 30th June 2005 30th June 2005 24th May 2005 30th September 2005 24th May 2005 30th June 2005 24th May 2005 15th June 2005 15th June 2005 Page 24 Cedar House F06 F56 S41209 Cedar House V228670 24.05.05 Stage 4.doc Version 1.30 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. Refer to Standard 2 2 17 33 33 Good Practice Recommendations To aid staff in locating relevant information quickly, care files should be more manageable with use of dividers for pertinent information A formal sytem should be put into place to ensure that all staff read the care assessment information and corresponding care plan. Residents should be able to choose from a range of foods offered daily, including desserts. The supper menu should also be more varied in line with residents preferences. The number of hours staff work should be better managed to avoid excessive hours being worked. Copies of certificates of training undertaken by staff should be held on personnel files at the home. Cedar House F06 F56 S41209 Cedar House V228670 24.05.05 Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection Turton Suite, Paragon Business Park, Chorley New Road, Horwich, Bolton, BL6 6HG. National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Cedar House F06 F56 S41209 Cedar House V228670 24.05.05 Stage 4.doc Version 1.30 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!